Pounding pain in the back of the brain

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By Bruce Chidester, Professor Emeritus University of Northern Iowa, and owner of  thetrumpetblog.com

Recently I was asked if I had ever experienced a momentary shot of pain to the back of my head after releasing a loud, high note while playing trumpet.

Fortunately I have not had that pleasure for some time now but I distinctly remember the experience.

After releasing a loud, high note (usually in about two to five seconds), it feels as if something climbs up the back of your neck and hits you in the back of the brain with a couple of pulsating shots, then goes away. If this sounds familiar to you, I may be able to help.

Years ago I was having these hits occurring every time I held a long, loud high note. This usually happened when the leader of the band wanted to get the last bit of applause out of his audience, never considering that the trumpets were about to have brain seizures. After many bouts with the uncomfortable suffering, I realized that the hits (usually two or three in lessening severity) coincided with my pulse. When one came on, I would check my pulse and sure enough, the multiple shots of pain were in sync with my pulse.

  • Important information #1- the pain had something to do with the blood flow to the brain.
  • Important information #2- my neck bulged when playing high and loud notes for extended time.
  • Important information #3- the swelling in my throat could be restricting the blood flow in the arteries running through my neck.


The expansion in the throat due to the sustained pressure in the throat restricts the blood flow to the brain and in turn starves the brain of blood until the note is released and the blood, which has been previously restricted, is released and the sudden surge of blood to the brain causes the pulsating pain which decreases in intensity.

Now that we know how this happens, what can we do to alleviate the pain?

I wish I could tell you that I struggled for days trying to come up with the solution to this uncomfortable experience but to be 100% truthful; I discovered the solution completely by accident. During one of these painful moments, by accident, I lowered my chin tight to my chest. I probably was getting set for the rush of blood to my brain. For some reason, the discomfort did not occur.

Luckily I noted this change and every time I anticipated the creepy, crawly thing running up the back of my neck, I quickly tilted my head down as far as possible, stretching the back of my neck and held that pose for at least five to ten seconds. After returning my head to a more normal position, I was relieved to find that I did not experience the normal shots to the back of my head.

If you have experienced this discomfort, try these steps to get rid of the pain-

  • Upon the release of your high, loud note, tuck you head as deep into your chest as you can.
  • Hold that position for about five seconds. You should feel the stretching of the back of your neck as you hold that position.
  • Slowly bring you head up.

My thoughts as to why this is effective are these

As the blood is restricted in the throat area, the brain is temporarily starved for blood. This is why many times players pass out after the note ends. As the blood is released, the shock of this rush of blood affects the brain by sending sharp pain to your senses.

By tucking your head deep into your chest, you are slowing down the surge of blood to a slower speed which the brain can manage more easily. In other words, by tucking your chin, you are equalizing the pressure to a more acceptable level.

My hypothesis may be completely wrong, but I do know that the exercise did work for me and it is my hope that it may give you some relief from the painful experience.

Note from the editor 1:
The above should not be considered medical advice. Should you experience any of the above symptoms for an extended period of time, due to brass playing or otherwise, you should consult with a medical professional immediately.
– Ed.

Note from the editor 2:
Prevention is always better than cure. Personally, I have never experienced the phenomenon of ‘brain pain’ or similar symptoms whilst playing the trumpet. It could be that certain individuals are more prone to the symptoms described above, whereas others are not.

Or alternatively, excess pressure felt in the head could be a result of inefficient and poor playing technique, or overly ‘tight’ equipment. Your thoughts and opinions on this topic are most welcome. Please use the comments section below to have your say.

6 Responses to “Pounding pain in the back of the brain”

  1. Jon Gorrie says:

    With respect to the author, I must say that the more I think about this concept of “brain pain”, the more I feel that it is due to overly tight equipment, poor body use and poor playing technique.

    A strong word of caution: The “brain pain” symptoms described above sound very similar to symptoms experienced by certain stroke sufferers, immediately before the onset of their stroke.

    One particular case comes to mind of a sufferer that was executing a very strong valsalva maneuver (“forcing out number twos”). He too experienced the “creepy crawly thing in the back of the neck” and woke up in hospital, having suffered a stroke. Luckily he survived, and functions now more or less like anyone else.

    Does anyone else have an opinion on “brain pain”?

  2. old-skool says:

    I’m inclined to agree with you; sounds like an MRI or Cat-Scan is in order, no disrespect to author.

  3. David says:

    Having suffered from Encephalitis on two seperate occassions, the pain and headaches I get I think are caused by both the lump of wastage I’ve got on the back of my brain, two which I’ve suffered two brain seizures over, as well as the joints on the neck and right shoulder that seems to send a shock wave off to the head which causes dizzyness, light headedness and headaches. Sometimes it even feels like the sinusitis that I used to have (which is a nightmare) feels like it’s trying to come back again and feels like it’s occuring more internally at the top of the temple region. Though one doctor I seen at one stage stated it is coming from the back of the brain that is causing sinasitis.

    The main things that seem to ease the headaches with myself are drawing, painting and playing music on my keyboard. I find it very relaxing and soothing, it’s like someone’s giving me a complete massage and managing to take away the pain with their magic touches. Though the only thing I don’t think is doing me any favour is running my website shopping directory Non-Stop-Shop, which I’ve done approximatelly 750,000 pages worth of work to.

    Thank God I got some lovely relaxing music to listen to whilst at work, which is performed by Kauzay and titled “The Power of Love”, it helps the day go through much easier.

  4. Thank you all for your opinions on the issue of “Brain Pain” and let me assure you that now at the age of 71, I am in excellent health and have had many (many) responses to the original article which enforce my original thoughts on the subject.

    I recently did have a MRI and Cat-Scan for a separate issue and was told that there is, and has never been any issues with my brain and their comments reinforced my original thoughts also.

    As I stated in the original post, most who suffer from this issue seem to out grow it as I did.

  5. Nate Locke says:

    I’ll try this method as soon as I play tomorrow. I have had severe throbbing pain that coincides with my pulse after playing picc and high trumpet. I have a masters in trumpet performance and will be pursuing an artists diploma soon and I must say I don’t think I’m using excess pressure from my arm or cutting off the airflow in my throat. Even if I play soft and in the low register on picc I still get throbbing headaches. Help, please, these headaches are standing between me and my dreams!

  6. Nate Locke says:

    …and I also had a MRI/Cat-Scan done and there was and was never any issues with my brain, which also leads me to think it’s all about blood circulation!

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